Please select which of the following you are concerned about or would like to discuss with your provider.
None of these
Create an account to save your progress
We will send important appointment and prescription notifications to your email address and phone number
What is your biological sex?
Your biological sex is important for your doctor to make medical decisions.
When were you born?
Your birthdate helps your doctor make medical decisions. This information will be kept confidential.
Let's start with the basics
Please answer the next 6 questions based on how you have felt and conducted yourself over the past 6 months.
If you are currently on ADHD medication, please answer the questions based on how you feel when you are not on the medication.